Mens Health Blog. Medical Blog

The recognition that changing behavior and attitudes may be a matter of life and death is a significant motivator for change. Many of our patients have reported that one of the benefits of their illness was that they could no longer ignore their true needs. The illness permitted them to override their social conditioning and begin to grow as humans beings: to express their feelings and go about meeting their needs openly and directly. Without the incentive of the illness, they could have continued to live lives of quiet desperation.It is essential to recognize that the needs being met through the illness are fully legitimate and deserve to be met. The body is demanding attention in the only way it knows how. Whether it is Willie’s need to feel that he has some control over his life, the psychiatrist’s need to resolve his guilt, the young professional’s need to balance his work with other parts of his life, or the businesswoman’s need to say no, all Of these are needs that human beings must meet to maintain their physical and emotional health. From this viewpoint, the intent of the organism is constructive, even in illness. Illness is an opportunity for the individual to achieve emotional growth.*37\347\2*

Comments (0) Jul 26 2011

Many women are acutely aware of the effects of hormones on their breast tissue. Many complain of swollen breasts, heaviness, discomfort or even increased ‘lumpiness’ each month, before menstruation. This is the clearest demonstration of the fact that breast tissue responds to hormone fluctuations, and pre-menstrual problems affect around 65 per cent of women. Three types of cell in the breast are sensitive to hormones: those lining the milk ducts, the glandular cells in breast lobules, and contractile cells responsible for squeezing milk out of the lobules.
The hormones oestrogen and progesterone are responsible for the changes that happen in a woman’s body at puberty, during menstruation, pregnancy, breast-feeding and when going through the menopause. The hormone prolactin is responsible for stimulating breast tissue to make milk, and rising levels pre-menstrually may be partially responsible, along with oestrogen and progesterone balance, for breast tenderness at this time. Prolactin levels are high in breast cancer patients and may be an even more potent stimulator of tumour growth than oestrogen.
There is a complicated feed-back mechanism between the hormone control centres (the hypothalamus and the pituitary) as they interact with hormone output from the ovaries. This regulates the quantities of hormones being secreted at any one time.
Oestrogens are secreted by the ovaries, the adrenal glands, fat cells and, in pregnant women, by the placenta. Though oestrogen is usually referred to as one hormone, the term really refers to a group of hormones that have a similar action. There are several types of oestrogen but the three most important are oestrone (El), oestradiol (E2) and oestriol (E3), all of which have slightly different functions and effects. El and E2 are the strong oestrogens associated with an increase in breast cancer risk, while E3 is the milder, benign oestrogen, mainly produced during pregnancy, which is 1,000 times weaker than oestradiol.
Progesterone is produced by the ovaries, and in pregnant women by the placenta. There is only one progesterone hormone produced in the body, although there are many types of artificial progestogens synthesized by the pharmaceutical industry.
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Comments (0) Dec 30 2010

Brenda is 51, married, with two children aged 14 and 19, and works as a nursing sister in an operating theatre at a large hospital.

A year ago she attended her first routine breast screening, and a week later received a letter asking her to return for a repeat mammogram. Brenda had had no breast problems, and was unable to feel a lump, but although the letter stated that the request did not mean that she had cancer, this was, of course, her overriding fear. She went immediately to talk to a surgeon at the hospital where she works, and he examined her breasts, finding no abnormality. Despite his reassurance, she found the next few days traumatic, and was unable to eat or sleep properly.

Brenda rang the breast screening clinic to cancel her appointment as she was sure there was nothing wrong, but was persuaded, rather unsympathetically in her opinion, not to do so.

At her second appointment, several mammograms were taken of both her breasts. She found the process uncomfortable, and felt that little was done to reassure or cheer her. After waiting a short time at the clinic while the X-rays were developed, she saw a doctor who explained that what had been detected on the original mammograms were tiny areas of calcification in her breasts which, on further examination, did not appear to be a cause for concern. The doctor thought they had probably been there for some time, and were likely to be quite a ‘normal’ aberration.

Brenda was very upset to discover that she had spent a week worrying about something that, as an experienced nurse herself, she would have been able to understand if it had been explained in the letter. She felt that the doctor was unsympathetic, and that the entire experience had been an unnecessarily distressing one.

Brenda was asked to return a year later for further mammograms and the doctor she saw immediately after these had been developed was very helpful and understanding. She explained to Brenda that the areas of calcification had not altered at all in the previous 12 months, and that she had nothing to worry about, but should return for further mammograms every 2 years.

Brenda’s relief at finding there was nothing wrong was tempered by her frustration about the difficult and anxious time she had had to spend. Although she appreciates that breast screening can play an important part in the early detection of breast disease, she does feel that there must be a better way of recalling women for further investigation.

*73/39/5*

Comments (0) Apr 22 2009